HomeMy WebLinkAbout2011-00910 - plumbing -� CITY OF ORONO PERMIT NO.: 2011-00910
2750 KELLEY PARKWAY
' ORONO, MN 55356- DATE IssuED: 08/22/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 880 PARTENWOOD RD
PIN : OS-117-23-43-0001
LEGAL DESC : PARTENWOOD
: LOT 006 BLOCK 001
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: 2ND FLOOR
1 WC,2 LAV, 1 TUB, 1 SHOWER
VALUATION OF PLUMBING 3500
APPLICANT PLUMBING FIXTURE FEE 50.00
MANATEE PLUMBING STATE SURCHARGE PLBG(VALUATION) 1.75
11525 199TH CIRCLE
SILVER LAKE,MN 55381- TOTAL 51.75
(612)756-1172
Minnesota State License#: 005923PM
OWNER
GRAY,JERRY&CYNTHIA
880 PARTENWOOD RD
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires sepazate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due caus
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A icant Perm e Signature Date Issued By i ature ate
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
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1�. City of Orono �� � �
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' 2750 Kelley Parkway �� e �
Crystal Bay,MN 55323 :A'ppro�earBy " � Amounf$ .
��o¢� (952)249-4600—Main
(952)249-4616—Fax
CITY OF ORONO — PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
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1. You may apply for plumbing permits by mail or in person at the City offices. Applicarions will be
reviewed and a permit will be issued within two working days.
2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property owners
residing in the dwelling.
4. When any new construcrion or remodeling is involved,a separate building permit must be
obtained.
5. All work must be done in accordance with State Code requirements.
6. All work must be inspected and air tested before it is covered. Call(952)249-4600.
(24-48 hour notice required)
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�Residential ❑ Commercial(Approval Required)
❑ New ❑Addirional ❑Repairs �eplace
❑ In Accessory Structure?
*You will need prior approval and may need CUP. (Per Orono City Code,Chapter 78,Article N)
7c������I O�er I�crr�t�%ation
Site Address: ��0 �G�r��rUJ UpC� I`�C1
Owner:�T��r`( � G� Y�r� Mailing Address:
City: �t(71(�n Zip:
Home Phone: �' Alternate Phone: lo I a—�56- 33�p
�v�st�c�r.I�'c�rt�a�on; ':
Contractor: MAvu.-�.re � �u rnbin� Contact Person: �� �� ��� t�-p�
Address: 1 I Sa 5 J`?�1 t�`���e. ( 4 State Bond#:
City: �i 1 v e Y �c� k-c Zip 3� Expiration Date:
Phone: �2 ��`�5�� ���a- Alternate Phone:
❑ Insurance—Current:
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FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet � Floor Drains
Lavatory � Sewer Ejector
Bathtub 1 Laundry Tray
�
Shower 1 Washer
1
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
❑ Yes,this section applies
The replacement of only one Residential fixture or appliance that meets all three of the following
requirements:
1. Does not require modificarion to electrical or gas service.
2. Has a total cost of$500.00 or less;excludinQ the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor.
Skip next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Negt Page)
2
.
If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
3��0 O x.0125$
(contract price) (minimum$50.00)
2. STATE SURCHARGE
x.0005 $
(contract price)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ ____ 2.00
4. TOTAL PERMTT FEE(Add Lines 1-3 Above) $
■ * CONTR.ACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including materials, labor,profit, and other fixed costs. It is the amount to be charged
to the customer for the work done. If any material, equipment, labor or installarions are furnished by
the owner, tenant or any other party, the reasonable market value of such items must be added to the
estimated cost or contract price for pernut fee purposes. In the event that there is a dispute on the
amount of the job cost, the City may request the submission of a signed copy of the actual contract.
The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements made on this application are complete, true and
correct.
Applicant's Signature: Date: C..�"aZ �� � +
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